The Medical School, University of Sheffield, Sheffield, UK.
Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Tech Coloproctol. 2021 Jun;25(6):675-682. doi: 10.1007/s10151-021-02432-9. Epub 2021 Mar 16.
Pilonidal sinus is a hole in the natal cleft which may cause severe pain and become infected. The evidence base for management of pilonidal sinus is said to be poor quality, poorly focused and rapidly proliferating. We undertook a systematic mapping review to provide a broad overview of the field and support the identification of research priorities.
We searched MEDLINE, CINAHL, and EMBASE from inception to 22nd Nov 2020 for primary research studies focused on the management of pilonidal sinus. We extracted data on study design and categorised studies under five major headings ('non-surgical treatment', 'surgical treatment', 'aftercare' and 'other'), producing frequency counts for different study designs. Gaps in research were identified from published systematic reviews and tabulated.
We identified 983 eligible studies, of which 36 were systematic reviews and/or meta-analyses; 121 were randomised controlled trials), and 826 observational studies of various design. The majority of studies evaluated surgical techniques (n = 665), or adjuvant medical interventions (n = 98). The literature on wound care has developed most recently, and the evidence base includes 30% randomised controlled trials. Gaps analysis highlighted comparison of surgical techniques including flaps, laser depilation, and wound care interventions as potential areas for randomised controlled trials.
This mapping review summarises eight decades of research on the management of pilonidal sinus. Further research is needed to identify front-running interventions, understand variation in practice and patient values, and to prioritise future research.
藏毛窦是会引起剧烈疼痛并感染的骶尾部裂隙中的一个窦道。藏毛窦的管理循证医学证据被认为质量差、针对性差且快速增长。我们进行了系统制图回顾，以提供该领域的广泛概述并支持确定研究重点。
我们从建库到 2020 年 11 月 22 日在 MEDLINE、CINAHL 和 EMBASE 中搜索了主要研究论文，这些研究论文的重点是藏毛窦的管理。我们提取了关于研究设计的数据，并将研究分为五个主要标题（“非手术治疗”、“手术治疗”、“后续治疗”和“其他”），对不同研究设计的研究进行频数计数。从已发表的系统评价中确定研究空白，并进行列表。
我们确定了 983 项符合条件的研究，其中 36 项为系统评价和/或荟萃分析；121 项为随机对照试验，826 项为各种设计的观察性研究。大多数研究评估了手术技术（n=665）或辅助医疗干预（n=98）。伤口护理文献发展最为迅速，证据基础包括 30%的随机对照试验。差距分析强调了比较手术技术，包括皮瓣、激光除毛和伤口护理干预，作为随机对照试验的潜在领域。
本制图回顾总结了 80 年来藏毛窦管理的研究。需要进一步研究以确定前沿干预措施，了解实践和患者价值观的差异，并确定未来研究的优先事项。
